Journal of Archives in Military Medicine
Volume:11 Issue: 3, Sep 2023

Diagnosing patient deterioration and preventing unexpected deaths in the emergency department is a complex task that relies on the expertise and comprehensive understanding of emergency physicians concerning extensive clinical data.

Our study aimed to predict emergency department mortality and compare different models.

During a one-month period, demographic information and records were collected from 1,000 patients admitted to the emergency department of a selected hospital in Tehran.We rigorously followed The Cross Industry Standard Process for data mining and methodically progressed through its sequential steps. We employed Cat Boost and Random Forest models for prediction purposes. To prevent overfitting, Random Forest feature selection was employed. Expert judgment was utilized to eliminate features with an importance score below 0.0095. To achieve a more thorough and dependable assessment, weimplemented a K-fold cross-validation method with a value of 5.

The Cat Boost model outperformed Random Forest significantly, showcasing an impressive mean accuracy of 0.94 (standard deviation: 0.03). Ejection fraction, urea (body waste materials), and diabetes had the greatest impact on prediction.

This study sheds light on the exceptional accuracy and efficiency of machine learning in predicting emergency department mortality, surpassing the performance of traditional models. Implementing such models can result in significant improvements in early diagnosis and intervention. This, in turn, allows for optimal resource allocation in the emergency department, preventing the excessive consumption of resources and ultimately saving lives while enhancing patient outcomes.

People traumatized by wars develop posttraumatic stress disorder (PTSD) and have low distress tolerance or emotional perception.

The present study aimed to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in response inhibition and cognitive flexibility of veterans with PTSD.

This quasi-experimental research adopted a pretest-posttest follow-up control group design. The statistical population included all the veterans supported by the Foundation of Martyrs and Veterans Affairs (FMVA) in Ahvaz, Khuzestan Province (Iran) in 2021. The purposive sampling method was employed to select 30 veterans who visited the psychological service centers affiliated with the FMVA of Ahvaz. They were then randomly assigned to the experimental (n = 15) and control (n = 15) groups. The participants in the experimental group received ten 60-minute EMDR therapy sessions held by the researcher, who underwent specialized training at the FMVA Counseling Center in Boustan Hospital. The participants in the control group received no intervention. The cognitive flexibility questionnaire and response inhibition scale were used to collect data. The analysis of covariance (ANCOVA) was used for data analysis in SPSS 24.

In the experimental group, the posttest and follow-up scores of response inhibition (response time) and cognitive flexibility showed significant improvements compared to pretest scores (P < 0.001).

Hence, EMDR therapy improved cognitive flexibility and response inhibition in veterans with PTSD. As a result, EMDR therapy can be employed to enhance the psychological characteristics of veterans with stress.

This study aimed to compare blood culture and serum levels of anti-Brucella antibodies between pregnancies leading to abortion and successful pregnancies.

In this case-control study, 60 women with spontaneous abortions were considered the case group, and 60 women with normal pregnancy outcomes were selected as the control group. Both groups were matched. The serology of IgM and IgG antibodies and blood culture was also compared using the enzyme-linked immuno-sorbent assay (ELISA) method. IgM and IgG levels above and equal to 12 were considered positive titers, and data were analyzed using SPSS software version 20.

The mean age of mothers (P  0.364), the frequency of positive blood cultures for Brucella (P  0.157), seropositivity of anti-Brucella IgG (P 0.300), and seropositivity of anti-Brucella IgM (P 0.057) showed no significant differences between case and control groups; however, mean serum levels of IgM were significantly higher in women with abortion than in the control group (P  0.042).

This study shows that Brucella seropositivity and positive blood culture are no more common in women with spontaneous abortions than in women with normal pregnancy outcomes. However, screening pregnant women for diseases in endemic areas, starting antibiotic treatment, and developing educational strategies for women of childbearing age will help prevent the disease and its adverse complications in pregnancy.

The use of massage as a safe method to control and manage complications after major surgery is recommended.

This study aimed to determine the effect of this method on arterial blood oxygen saturation and temperature changes in patients after abdominal and thoracic surgery.

This quasi-experimental study was conducted on 60 patients undergoing surgery in Shahrekord city in 2019. They were enrolled in the study by convenience sampling and assigned to the intervention and control groups by the blocking method. In the intervention group, a hand and foot massage was performed at 5-minute intervals for 4 sessions on each patient’s limb 3 times a day. The control group received routine care. Data were collected by a demographic questionnaire, pulse-oximetry, and thermometer. They were analyzed using SPSS version 16 and descriptive and inferential statistical tests (t-test, paired t-test, and analysis of variance (ANOVA)).

The mean arterial blood oxygen saturation in the groups after the intervention did not show a significant difference compared to before (P = 0.95), but its mean was significantly higher in the intervention group after the intervention than before (P < 0.001). The mean temperature in the 2 groups after the intervention did not show a significant difference compared to before (P = 0.38), but the changes in the mean were significant in the massage group after the intervention compared to before (P = 0.019).

The hand and foot massage can be used by nurses along with the required medical care to improve arterial blood oxygen saturation and reduce body temperature. Further research in this area is suggested.

In the summer of two years ago in 2021, the prevalence of COVID-19 increased sharply in one of the less privileged provinces. As a result, the number of beds and treatment departments in hospitals, and more importantly, the number of medical specialists in that province, did not meet the existing needs. For this reason, the military healthcare workers decided to come to the aid of that province, considering the organizational mission of the police force. According to the memorandum, the Police Organization, the Governor, and the University of Medical Sciences from that province collaborated to establish a 64-bed field hospital for patients with COVID-19, with two separate wards for male and female patients. The COVID-19 Police Field Hospital provided care for more than a thousand patients over 8 weeks from July 12 to August 31, 2021. In this report, we describe our implementation strategy, including organizational structure, acceptance criteria, and clinical services. Additionally, dynamic workflows require clear lines of relationship, clinical operations expertise, and engaged, interested, and people-friendly healthcare workers.